Kaseje Neema, Pinard Jacquemine, Louis Willy Fils Jean, MacLee Jean Louis, Jeudy Andre Patrick, Ford Henri
Surgical Systems Research Group, Tropical Institute of Community Health, PO Box 2224, Kisumu, Kenya.
Hôpital Universitaire Mirebalais, Mirebalais, Haiti.
Pediatr Surg Int. 2018 Aug;34(8):891-895. doi: 10.1007/s00383-018-4302-9. Epub 2018 Jul 2.
In resource-limited settings, up to two-thirds of surgical patients develop surgical site infections (SSIs). Our aim was to implement a multimodal protocol including an occlusive dressing and parental engagement to achieve low SSI rates in patients undergoing elective ambulatory pediatric surgery at a tertiary center in Haiti.
An observational retrospective review of pediatric patients who underwent elective ambulatory procedures from August 2015 to May 2016 following the implementation of a multimodal protocol consisting of: washing and prepping the operative site with chlorhexidine; review of the surgical safety checklist; one dose of cefazolin before incision; after wound closure application of steri strips, gauze, and tegaderm; and with parental engagement maintenance of the dressing until the follow-up visit.
We performed 119 procedures in 99 patients. Mean age was 6.2 years. The most common procedure was inguinal hernia repair (66%); 89% of parents returned to clinic with their children for the follow-up visit, which occurred on average on day 7.6 (range 3-40 days). The SSI rate was 1% (CI 0.00-0.03).
Implementing a multimodal protocol including an occlusive dressing and parental engagement led to a 1% SSI rate in a resource-constrained setting.
在资源有限的环境中，多达三分之二的外科手术患者会发生手术部位感染（SSI）。我们的目标是实施一项多模式方案，包括使用封闭敷料和让家长参与，以在海地一家三级中心接受择期非住院儿科手术的患者中实现低SSI发生率。
对2015年8月至2016年5月期间接受择期非住院手术的儿科患者进行观察性回顾，该回顾遵循一项多模式方案，包括：用氯己定清洗和准备手术部位；审查手术安全检查表；切开前一剂头孢唑林；伤口闭合后应用无菌胶带、纱布和皮肤保护膜；以及让家长参与，维持敷料直至随访就诊。
我们对99例患者进行了119例手术。平均年龄为6.2岁。最常见的手术是腹股沟疝修补术（66%）；89%的家长带着孩子返回诊所进行随访，随访平均在第7.6天（范围3 - 40天）进行。SSI发生率为1%（可信区间0.00 - 0.03）。
在资源受限的环境中，实施包括封闭敷料和家长参与的多模式方案导致SSI发生率为1%。
